Round ligament pain in pregnancy: causes, symptoms, and exercises for relief

It’s official. Your belly bump is undeniable and you’re finally showing. But this fun part of pregnancy can come with some aches and pains around your middle — better known as round ligament pain. It happens as your body stretches to accommodate your growing baby. Up to 30% of pregnant women experience round ligament pain, most often at the start of the second trimester.   

There’s a lot you can do at home, like gentle exercises and stretches, to help relieve round ligament pain. Read on to learn why round ligament pain occurs during pregnancy and how to ease it, especially with stretching exercises from our Hinge Health physical therapists.

What is round ligament pain?

Round ligament pain is discomfort you feel in your lower abdomen, hips, pelvis, or groin during pregnancy. Your round ligaments are two rope-like bands of connective tissue attached to either side of your uterus. They connect the front part of your uterus to your groin, and help hold the uterus in place. As your womb expands, it puts tension on those supporting ligaments, which can lead to pain — especially with sudden movements.

Round ligament pain is a normal pregnancy symptom. Typically, round ligament pain occurs during the second trimester (weeks 14 to 27), and often eases soon after delivery, when your uterus starts to shrink back to pre-pregnancy size.

Symptoms of round ligament pain  

Round ligament pain can feel different for different people. Symptoms may include:  

• Cramping

• Sharp pain, a stabbing sensation, or a dull ache

• Pulling sensations

You might feel pain in the lower part of your pelvis or hip area, on one or both sides. It may also radiate to your groin area. Round ligament pain typically lasts only a few seconds or minutes. You may experience it more frequently if you are carrying twins or triplets.

Causes of round ligament pain

To help support your growing uterus, your round ligaments stretch and widen. The extra pull, or tension, on the ligaments can cause aches and pains in your abdomen. Round ligaments normally contract and relax slowly. When they are stretched and strained, any sudden or abrupt movement that causes the ligaments to tighten quickly can lead to pain. Common triggers of round ligament pain include: 

• Changing positions — such as standing up — too quickly

• Rolling over in bed

• Laughing, sneezing, or coughing

• Certain forms of exercise

When is round ligament pain during pregnancy a red flag?

Although round ligament pain is common and usually related to musculoskeletal (MSK) issues, it can sometimes be a warning sign of serious pregnancy complications, such as a uterine rupture or ectopic pregnancy rupture. Watch for round ligament pain that doesn’t ease after resting or changing positions, or if severe pain comes with vaginal bleeding, vaginal discharge, fever, nausea, or contractions. See your provider right away if you have abdominal pain with any other symptoms.

Treatments for

round ligament pain in pregnancy 

There’s a lot you can do to relieve round ligament pain during pregnancy. Options include:

• Exercise. This can help strengthen the muscles that surround the round ligaments, providing extra support, explains Samantha Charlotin, PT, DPT, a Hinge Health pelvic floor physical therapist. Improving the coordination and strength of your abdominal, hip and pelvic floor muscles can lessen the load placed on your ligaments during movement, which can help ease symptoms. “Yoga is a gentle way to stretch and strengthen muscles during pregnancy,” says Dr. Charlotin. “Swimming is also a great option, as it helps take the weight off your uterus, joints, and ligaments as you exercise.” 

• Physical therapy. A physical therapist (PT) can help you learn stabilizing and strengthening exercises for your abdominal, hip, and pelvic floor muscles, which can help ease discomfort. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. (See PT-recommended exercises for round ligament pain below.)

• Rest. Comfortable positions that reduce the strain on your round ligament can help ease and prevent round ligament pain. Lie on your side to take pressure off your round ligaments and improve blood flow. Use pillows to support your belly and reduce round ligament strain.

• Consider a belly band. These are worn low on your abdomen and can help support your belly by pulling your baby off your pelvis, which may help relieve round ligament pain. 

• Practice relaxation techniques. Deep breathing and meditation can help relax your muscles and reduce stress, which can contribute to pain relief.

• Take a warm bath. This can help relax tense muscles and reduce pain. 

• Over-the-counter (OTC) medication. Acetaminophen (Tylenol) has been shown to be safe for pain relief during pregnancy. It’s important to make sure that you are safely able to take any medications, based on your medical history. Avoid NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen as some research shows increased risks with these drugs during pregnancy.

These exercises are recommended by Hinge Health physical therapists to help relieve round ligament pain during pregnancy. They help to stretch and strengthen abdominal, hip and pelvic floor muscles, which can help reduce strain on ligaments and ease symptoms.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Round ligament pain prevention in pregnancy

It’s not always possible to prevent round ligament pain. But there are things you can do to help lessen the stress on your round ligaments, and reduce sudden movements that may cause pain, such as:

• Be mindful of sudden or twisting movements while lifting objects.

• Change positions frequently and avoid standing for long periods of time. 

• Change positions slowly. Try to avoid standing, sitting, or rolling over suddenly.

• Lean forward or hold your belly for support when you laugh, sneeze, or cough. 

• Bend and flex your hips throughout the day. Try some seated marches, or bringing your knees towards your chest while lying on your side.

PT tip: Give your body grace

Round ligament pain can be sudden and uncomfortable. “But it might show that your body is doing exactly what it should: expanding your uterus to make room for your growing baby,” says Dr. Charlotin. “With exercise and other adjustments, the pain can be managed.” Still, discuss any new symptoms with your provider to make sure they are a normal part of pregnancy and not a sign of something more serious.

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Best sleeping positions during pregnancy. (2021, September 1). American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/sleeping-positions-while-pregnant

2. Changes During Pregnancy. (n.d.). Www.acog.org. https://www.acog.org/womens-health/infographics/changes-during-pregnancy

3. Chaudhry, S. R., & Khalid Chaudhry. (2018, December 15). Anatomy, Abdomen and Pelvis, Uterus Round Ligament. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499970/

4. Rishi Dhamecha, Sandhya Pajai, & Bhasin, T. (2023). Acute Abdomen in Pregnancy: A Comprehensive Review of Diagnosis and Management. Cureus. doi:10.7759/cureus.40679

5. Round Ligament Pain During Pregnancy. (2018, February 27). American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/round-ligament-pain-during-pregnancy/

6. What You Should Know About Round Ligament Pain | Kaiser Permanente. (2022, July). Healthy.kaiserpermanente.org. https://healthy.kaiserpermanente.org/hawaii/health-wellness/healtharticle.round-ligament-pain